Please enter all your details to enroll

Contract Option

Registration Fee Options (Per Swimmer): *

R360 = Once off registration fee (Includes registration pack)

Contract option:

Month to Month R300 p/h

Swimmers Details

Section A

Nickname *

Surname *

Certificate Name *

This name will be displayed on the certificate

Age *

Date of Birth *

Gender *

Male

Female

Academic School Attending *

Grade *

Previous Swim Lessons *

Yes

No

Swimming Ability *

Beginner

Water Confident

Stroke Development

For adult swimmers only

Cellphone number

Email *

Can we send you marketing info? *

Yes

No

Medical Information

Section B

Near Drown Experience *

Yes

No

Near Drown Experience: If Yes, Explain

Parents Details

Section C

Dad Name & Surname *

Dad Cellphone Number *

Mom Name & Surname *

Mom Cellphone Number *

Emergency Contact

Section D

Emergency Contact Name & Surname *

Relationship *

Emergency Contact Cellphone Number *

WhatsApp Communication Details

Section E

WhatsApp Name & Surname *

WhatsApp Cellphone Number *

Photography / Video Consent

Section F

Photography / Video Consent *

Yes

No

Terms & Conditions

Section G

View T's & C's

Terms & Conditions *

Accept

Bus Indemnity acceptance if School Group Contract is selected

Signature *

Clear